No-one to act as my POA. What to do? Am I screwed if something bad happens?

For various reasons, I don't have anyone able or willing to be my health care proxy/POA if/when the time comes that I need one. (Unmarried, only child, parents not capable, no other close family, and two closest friends not willing/able.) So how do I prevent myself from becoming another Terri Schiavo should the worst happen? Find someone super-quick and get married? Join a church (I'm agnostic)? Pay a professional (I can't really afford it)? Get a human-brain transplant for one of my pets? (Ha ha.)

Is there any particular reason why you really need a sentient being making decisions instead of a well-thought out living will? Certainly you can avoid becoming Terri Shiavo without much trouble.posted by floam at 6:37 PM on March 5, 2010

Find out what the norms are in your state; many people simply don't need a health care proxy, either because advance directives take care of it, or because you're comfortable with the decisions that your doctors will undertake.

If you need a health care proxy and you don't have one, most states (maybe all) have a "public guardian" who is appointed specifically to do this; my husband goes to court all the time to have the state's public guardian appointed for individuals in comas, etc., who have no "next of kin" and no written wishes. (He does some work for local hospitals.)

Are you ill such that this is an immediate concern? Personal circumstances change. But most people don't end up needing a health care proxy.posted by Eyebrows McGee at 6:53 PM on March 5, 2010 [1 favorite]

I agree, create a living will and establish it with an attorney you trust.

A clear living will should do the trick. I think having a health care proxy would be more useful when you have some relatives wanting to keep you on life support forever and the other half trying to pull the plug. Talk to a lawyer experienced with creating living wills then be very specific about your wishes.posted by MsKim at 7:00 PM on March 5, 2010

Is there any particular reason why you really need a sentient being making decisions instead of a well-thought out living will? Certainly you can avoid becoming Terri Shiavo without much trouble.

Because in the real world you need an advocate to bring that living will to everyone's attention. That public guardian is new to me but having a way of getting that living will in their hands would work most likely.posted by caddis at 7:02 PM on March 5, 2010

I am seconding caddis on this one. Just because you have a living will doesn't mean that the medical establishment will honor it without someone there to make sure it's adhered to. I've seen this situation three times now, most recently with my grandfather who died three weeks ago. He needed to have surgery that only had a 50/50 chance of a good outcome because he had a very weak heart. Before having the surgery, he went over his living will with the doctors, and was explicit that if things did not go as planned, he did not want any interventions to prolong his life. There was a copy in his chart. But after the surgery, when it was clear he was dying, my mom and aunt still walked in to find a nurse giving him units of blood, and putting him on IV drugs that artificially raised his blood pressure. They had to be very firm with the staff that they expected his wishes to be honored. And they had to intervene at least one other time when another doctor in the ICU got aggressive with his care.

A piece of paper isn't enough, and neither is an attorney. Someone really needs to be there to make sure that the medical facility knows the conditions of your living will, and that they honor those conditions.posted by kimdog at 7:17 PM on March 5, 2010 [2 favorites]

Preventing being on life support for years if you're braindead is a lot easier than saying no to the standard practice of giving medicine to save lives like kimdog is describing. I don't think you'd need a person for that, and I'm pretty positive most doctors would adhere to something that they'd prefer to do anyways, which is not keep a brainded person plugged in. In fact, I'd almost go so far as to bet you really shouldn't have to worry about things at all, since it takes a person in that role screwing things up to get into a Terri Shiavo type problem in the first place.

I really doubt you're in a bad spot here without anybody that's POA, going by the tone of your post which suggests you're not trying to do anything unreasonable or outside of normal.posted by floam at 7:25 PM on March 5, 2010

kimdog is right. You really need someone there IN PERSON advocating for your wishes. And if that person doesn't agree with you, you're screwed. Which explains how my dad was on life support for 2 years even though he had a living will.

I have a similar problem in that I can't rely on my relatives and can't count on friends being able to be there in person/consistently to advocate for me in this situation. How does this public guardian thing work, again?posted by jenfullmoon at 10:48 AM on March 6, 2010

If you are currently ill, this is a priority. Otherwise, once you've done a living will, spend some time making friends. Not only are friends able to help you in times of dire need, a life rich in friends is much nicer, and helps you stay healthier.posted by theora55 at 11:42 AM on March 6, 2010

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